H.R. 1300 — PSA Screening for HIM Act

This section establishes the short title as the “Prostate-Specific Antigen Screening for High-risk Insured Men Act” or the “PSA Screening for HIM Act.”

This section sets forth congressional findings on prostate cancer, including that it is the second leading cause of cancer death in men in the United States, with 1 in 44 men expected to die from the disease and more than 35,700 men estimated to die in 2025; that it is the second most commonly diagnosed cancer, with 1 in 8 men diagnosed in their lifetimes, 3.3 million men living with a diagnosis, and more than 310,000 men estimated to be diagnosed in 2025; that early-stage prostate cancer has a near-100 percent survival rate while late-stage disease has a 37 percent survival rate; that African-American men are 70 percent more likely to be diagnosed than White men, with 1 in 6 expected to develop prostate cancer in their lifetimes and 2.1 times more likely to die from the disease; and that men with a father or brother with prostate cancer are more than twice as likely to be diagnosed. The findings also state that major cancer and urological societies recommend earlier screening discussions for African-American men and men with a family history, that the United States Preventive Services Task Force has identified research on screening African-American men, including at younger ages, as a high-priority cancer research gap, and that barriers to screening should be minimized for high-risk men to detect asymptomatic disease before metastasis. The section further notes that treating metastatic prostate cancer costs the U.S. health care system hundreds of millions of dollars more each year than treating localized, early-stage cancer.

This section revises the preventive services coverage requirements under section 2713 of the Public Health Service Act (42 U.S.C. 300gg–13) to require group health plans and health insurance issuers offering group or individual health insurance coverage to cover, without cost sharing, evidence-based preventive services rated A or B by the U.S. Preventive Services Task Force, recommended immunizations, and specified preventive care for infants, children, adolescents, and women, and it adds prostate cancer screening coverage for men age 40 and over who are at high risk of developing prostate cancer, including African-American men and men with a family history of prostate cancer. As background, section 2713 generally requires most private health plans to cover certain preventive services without deductibles, copayments, or coinsurance. The section defines “men with a family history of prostate cancer” to include men with a first-degree relative who was diagnosed with, developed, or died from prostate cancer, or who has a cancer or genetic alteration associated with increased prostate cancer risk. It also provides that, for purposes of this Act and any other provision of law, the current U.S. Preventive Services Task Force recommendations on breast cancer screening, mammography, and prevention exclude those issued in or around November 2009. The amendment applies to plan years beginning on or after January 1, 2026.